Medicine
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This study aimed to determine the maximum tolerated dose (MTD), dose-limiting toxicity, and efficacy of second-line chemotherapy with FOLFIRINOX after gemcitabine (GEM)-based chemotherapy failure in metastatic pancreatic cancer (MPC). ⋯ The recommended dose was 85 mg/m oxaliplatin, 100 mg/m irinotecan, and 400 mg/m leucovorin, followed by 400 mg/m 5-FU as a bolus on day 1 and 2400 mg/m 5-FU as a 46-hour continuous infusion. These results indicate that second-line FOLFIRINOX is a marginally effective treatment for GEM-based chemotherapy failure cases.
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Stent fracture has received increased concern as it may be an important risk factor for late stent failure, intravascular ultrasound (IVUS) is always recommended to confirm the diagnosis of stent fracture. StentBoost can detect stent fractures more easily due to the enhanced stent strut visibility, compared with coronary angiography (CAG). Few cases were reported to compare the advantages of StentBoost vis-à-vis IVUS in detecting stent fracture. ⋯ StentBoost may distinguish partial, complete, or multiple stent fracture, even which sometimes is not obvious in IVUS, StentBoost is a useful and handy tool for identifying the stent struts.
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Review Meta Analysis
Meta-analysis of studies using metformin as a reducer for liver cancer risk in diabetic patients.
Metformin has garnered more interest as a chemo-preventive agent given the increased liver cancer risk in diabetic patients. This work was undertaken to better understand the effect of metformin use on liver cancer risk in diabetic patients. A comprehensive literature search was performed in PubMed, Embase, BIOSIS Previews, Web of Science, and Cochrane Library through July 30, 2016. ⋯ After adjusting for hepatitis B/C virus infection, cirrhosis, obesity, behavioral factors, and time-related bias, the association was stable, pooled OR ranged from 0.42 to 0.75. A protective effect for liver cancer was found in diabetic metformin users. However, more randomized clinical evidence is still needed to verify the results.
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Review Meta Analysis
Network meta-analysis of Chinese herbal injections combined with the chemotherapy for the treatment of pancreatic cancer.
This study sought to use a network meta-analysis to assess the effectiveness and safety of Chinese herbal injections (CHIs) combined with the chemotherapy for the treatment of pancreatic cancer. ⋯ The current evidence showed that using CHIs on the basis of the chemotherapy could be beneficial for patients with pancreatic cancer in improving performance status and reducing the ADRs.
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Observational Study
A selective screening program for the early detection of mucopolysaccharidosis: Results of the FIND project - a 2-year follow-up study.
The mucopolysaccharidoses (MPSs) are underdiagnosed but they are evaluated in few newborn screening programs, probably due to the many challenges remaining, such as the identification of late-onset phenotypes. Systematic screening at the onset of clinical symptoms could help to early identify patients who may benefit from specific treatments. The aim of this prospective study was to assess a novel selective screening program, the FIND project, targeting patients aged 0 to 16 years with clinical manifestations of MPS. ⋯ The mean time from onset of clinical symptoms to detection of MPS was 22 months, and just 2 cases were detected at the beginning of the project were detected with 35 and 71 months of evolution of clinical symptoms. Our screening strategy for MPS had a sensitivity of 100%, a specificity of 85%, and a positive predictive value of 24%. The FIND project is a useful and cost-effective screening method for increasing awareness of MPS among pediatricians and enabling the detection of MPS at onset of clinical symptoms.